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ICD-10 Guide
ICD-10 CodesH02.235

H02.235

Billable

Paralytic lagophthalmos left lower eyelid

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 H02.235 is a billable code used to indicate a diagnosis of paralytic lagophthalmos left lower eyelid.

Key Diagnostic Point:

Paralytic lagophthalmos of the left lower eyelid is characterized by the inability to completely close the eyelid due to paralysis of the facial nerve, often resulting from conditions such as Bell's palsy, stroke, or trauma. The left lower eyelid's inability to close can lead to exposure keratitis, dry eye syndrome, and potential corneal damage. The eyelid anatomy includes the orbicularis oculi muscle, which is responsible for eyelid closure, and its dysfunction can significantly impact ocular health. Disease progression may involve initial symptoms of facial weakness, followed by complications such as irritation, inflammation, and infection of the ocular surface. Diagnostic considerations include a thorough clinical examination, patient history, and possibly imaging studies to assess the underlying cause of the paralysis. Treatment may involve protective measures for the eye, such as lubricating eye drops or surgical interventions to improve eyelid closure. Understanding the periocular anatomy and the lacrimal system is crucial for managing the complications associated with lagophthalmos effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors include misidentifying the affected eyelid or failing to document the underlying cause of paralysis.
  • Documentation gaps may arise from insufficient detail regarding the patient's history and clinical findings.
  • Billing challenges can occur if the treatment plan is not clearly outlined or if there are discrepancies between the diagnosis and the procedures performed.

Specialty Focus

Medical Specialties

Ophthalmology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Neurology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Paralytic lagophthalmos can significantly affect a patient's quality of life, leading to complications such as corneal abrasions and chronic dry eye. Understanding its prevalence and impact on population health is essential for developing effective treatment strategies. Quality measures should focus on timely diagnosis and management to prevent ocular complications, thereby reducing healthcare utilization patterns associated with untreated eyelid disorders.

ICD-9 vs ICD-10

Paralytic lagophthalmos can significantly affect a patient's quality of life, leading to complications such as corneal abrasions and chronic dry eye. Understanding its prevalence and impact on population health is essential for developing effective treatment strategies. Quality measures should focus on timely diagnosis and management to prevent ocular complications, thereby reducing healthcare utilization patterns associated with untreated eyelid disorders.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the treatment, the necessity of protective measures for the eye, and any surgical interventions performed. Common denials may arise from insufficient documentation of the diagnosis or failure to link the procedure codes to the diagnosis. Best practices include ensuring that all documentation is complete and aligns with the coding guidelines to support the medical necessity of the services rendered.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for H00-H99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for H00-H99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by H02.235?

H02.235 covers conditions leading to paralysis of the left lower eyelid, primarily due to facial nerve dysfunction. This includes Bell's palsy, traumatic nerve injury, and post-surgical complications affecting eyelid function.

When should H02.235 be used instead of related codes?

H02.235 should be used specifically when the left lower eyelid is affected by paralytic lagophthalmos. It is essential to differentiate it from right-sided paralysis (H02.234) and other eyelid disorders that do not involve paralysis.

What documentation supports H02.235?

Documentation should include a detailed patient history, clinical examination findings, and any imaging or diagnostic tests performed. Evidence of the underlying cause of paralysis and treatment plans should also be clearly documented.